| Organization Name: | ADVANCED CHIROPRACTIC & REHAB, INC. |
| NPI Number: | 1093172868 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL LYONS (OWNER) |
| Mailing Address: | 755 Boardman Canfield Rd Suite P-1 Boardman |
| State: | OH US |
| Postal Code: | 445124300 |
| Phone Number: | 3307267404 |
| Fax Number: | 3307299166 |
| NPI Enumeration Date: | 01/25/2016 |
| NPI Last Update Date: | 01/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | PT005210 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |